Document Sample
					                                                      BCS Medical Insurance Card
        MEDICAL INSURANCE IDENTIFICATION CARD                                                   IEES CONTACT INFORMATION:
             International Student Exchange Programs                                            This card should be presented to your service provider before receiving
 Participant: Damir VAGAPOV - 28236                                                             treatment. Please refer all questions regarding medical benefits and submit
 is enrolled in the ISEP health and accident plan, underwritten by BCS                          claims to:
 Insurance Co., Policy No. IES-00002.                                                           IEES, P. O. Box 370, Ithaca, NY 14851-0370
 Effective Date: 1/1/2011 - 6/1/2011                   (12:01 AM)                               Toll free in USA 866 433 7462 or 607 272 2707 (collect from overseas)
 For Medical claims, questions or concerns contact IEES. Although referrals are not required,   Fax: 607 272 2703 e-mail: web:
 they are available by visiting and selecting the “Search for Doctor/ Hospital”
 option (available in USA only.)                                                                Emdeon Payer ID: 16158
                                                                                                In the event of a Death or Medical Evacuation or for Assistance services,
                                                                                                please contact MEDEX. Consult your MEDEX ID card for world-wide telephone
                                                                                                This card is for identification purposes only and in no way guarantees benefits.
                                                                                                All benefits are subject to Policy Provisions, Limitations and Exclusions.

IEES is the Third Party Administrator which administers your insurance policy and processes the medical claims for BCS
Insurance Company. BCS is the insurance company which underwrites the medical benefits portion of your insurance policy.

Call IEES if you have general inquiries regarding your medical benefits, eligibility, claim status or reimbursement issues. If
IEES is closed and you have a true emergency with respect to one of these areas, please contact MEDEX Assistance
Corporation as they can contact our staff after hours. (Refer to your MEDEX Identification Card.)

If you have any other issues regarding your medical coverage contact IEES direct during regular business hours.
(See IEES CONTACT INFORMATION on BCS Medical Insurance Card.)

Yes. Your policy is an indemnity plan which allows you to go to the physician or hospital of your choice.

WITHIN THE USA Find information on participating providers by visiting the IEES webpage at and select the
"Search for Doctor/Hospital" option on the home page. When you contact a medical provider, tell them that you have a policy
which particpates with First Helath/ Hygeia.

Please remember you are not required to see a Hygeia provider and are not penalized if you choose to see a different

OUTSIDE THE UNITED STATES You can phone MEDEX ASSISTANCE CORPORATION collect at 410-453-6330 for a
BCS Medical Insurance provides health benefits.
Please present this card to you medical provider, not your MEDEX card.

Health Insurance Program

Please note that, except in the case of catastrophic health care, you may need to pay for your medical
treatment and then be reimbursed. Make sure that your budget is flexible enough to cover any
unforeseen health care expenses. In the case of a major medical procedure or hospitalization, please
contact the provider to verify proof of coverage and to coordinate payment.

Insurance Coverage

This insurance will cover medical expenses related to sickness or injury, in excess of the $25 deductible
per incident, that you incur outside your home country while on an ISEP exchange up to a maximum of
$300,000. Prescription drugs and medicines are payable at 80 percent for outpatient treatment and at
100 percent on an inpatient basis.

For complete policy information and a claim form, please go to
            Here is your MEDEX Identification Card
                                                                       WORLDWIDE 24-HOURS A DAY

  When traveling, you can now feel confident that you are in safe hands if an emergency
    arises. MEDEX provides medical, security and travel-related assistance services.

 Always carry your MEDEX identification card with you. Listed on the back of the card are
   the telephone numbers for the worldwide MEDEX network. When you call MEDEX, be
    prepared to provide your MEDEX ID number, organization’s name, your name and a
                              description of the situation.

MEDEX PORTFOLIO OF SERVICES:                                                                       MEDICAL EVACUATION AND REPATRIATION SERVICES
                                                                                                   Emergency Medical Evacuations
MEDICAL ASSISTANCE SERVICES                                                                        Transportation to Join a Hospitalized Member
Worldwide Medical and Dental Referrals                                                             Return of Dependent Children
Monitoring of Treatment                                                                            Transportation After Stabilization
Facilitation of Hospital Payments                                                                  Repatriation of Mortal Remains
Transfer of Insurance Information to Medical Providers
Medication, Vaccine and Blood Transfers                                                            PERSONAL SECURITY SERVICES
Dispatch of Doctors and Specialists                                                                Political Evacuation Services
Transfer of Medical Records                                                                        Security Evacuation Services
Continuous Updates to Family, Employer and Home Physician                                          Transportation After Political or Security Evacuation
Hotel Arrangements for Convalescence
Replacement Corrective Lenses and Medical Devices                                                  FREQUENTLY ASKED QUESTIONS:
TRAVEL ASSISTANCE SERVICES                                                                         WHO IS MEDEX? Since 1977, MEDEX has been assisting travelers worldwide by utilizing highly trained,
Replacement of Lost or Stolen Travel Documents                                                     multilingual coordinators in conjunction with an extensive information and communication system to provide
Emergency Travel Arrangements                                                                      medical and travel-related assistance.
Transfer of Funds                                                                                  WHEN SHOULD I CONTACT MEDEX? Coordinators are available 24-hours a day, every day of the year. Many
Legal Referrals                                                                                    times people assume that the services are to be used only in serious cases. Be assured that MEDEX is there
Translation Services                                                                               to help you with any type of problem regardless of the severity.
Message Transmittals                                                                               WHAT IF LOCAL MEDICAL FACILITIES ARE INADEQUATE? If, through its medical management, MEDEX
Emergency Pet Housing and/or Pet Return                                                            determines that local medical providers are inappropriate for treatment, MEDEX will arrange for a medically
                                                                                                   safe evacuation to a facility capable of providing the necessary care.
Pre-Travel Information                                                                             WHAT HAPPENS IF I AM HOSPITALIZED? It is important to notify MEDEX as soon as possible. MEDEX will
Travel and Health Information                                                                      immediately contact your treating physician to assess your condition and treatment plans to ensure your safe
Real-Time Security Intelligence                                                                    recovery. MEDEX will then update your family, employer/organization and personal physician as appropriate.
                                                                                                   MEDEX will assist you until you have returned home or have received final treatment.

                                                        Detach and carry with you at all times.

                                                                                                                                            MEDEX EMERGENCY RESPONSE CENTER:
                                                                                                                                                 United States, Baltimore, MD 1-410-453-6330
                                                                                                                                     TOLL FREE ACCESS - The numbers below must be dialed from within the country.
                                                                                                                                If your location is not listed or the call will not go through, call the 24-hour Emergency Response Center COLLECT.
            MEDEX ID: 319691                                                                                                  Australia and Tasmania:                     1-800-127-907 Mexico:                                001-800-101-0061
                                                                                                                              Austria:                                    0-800-29-5810 Netherlands:                              0800-022-8662
            Client Name: IEES                                                                                                 Belgium:
                                                                                                                                                                            0800-1-7759 New Zealand:
                                                                                                                                                                         0800-891-2734 Philippines:
                                                                                                                              China (northern regions):       108888 * 800-527-0218 Portugal:                                       0800-84-4266
            Group Name: INT’L STUDENT EXCHANGE PROGRAM                                                                        China (southern regions):        10811 * 800-527-0218 Republic of Ireland (Eire):                    1-800-409-529
                                                                                                                               Dominican Republic                       1-888-567-0977 Republic of South Africa:                    0800-9-92379
            Member Name: Damir VAGAPOV                                                                                        Egypt (inside Cairo)        2-510-0200 * 877-569-4151 Singapore:
                                                                                                                              Egypt(outside of Cairo): 022-510-0200 * 877-569-4151 South Korea:
                                                                                                                              Finland:                                     0800-114402 Spain and Majorca:                            900-98-4467
            Valid Dates: 1/1/2011 - 6/1/2011                                                                                  France and Monaco:                          0800-90-8505 Switzerland and Liechtenstein:               0800-55-6029
                                                                                                                              Germany:                                   0800-1-811401 Thailand:                            001-800-11-471-0661
                                                                                                                              Greece:                                00-800-4412-8821 Turkey:                                  00-800-4491-4834
                                                                                                                              Hong Kong:                                    800-96-4421 U.K., N. Ireland, Isle of Jersey, the Channel
         If you need assistance, call MEDEX immediately for benefits verification and procedures.                             Indonesia:                           001-803-1471-0621         Isles and Isle of Man:                 0800-252-074
        Please note this policy provides assistance, medical evacuation, repatriation, and personal                            Israel:                                   1-809-41-0172 United States, Canada, Puerto Rico,
            security services. MEDEX does not provide or have details regarding actual medical
                                                                                                                              Italy, Vatican City and San Marino:           800-877-204      US Virgin Islands, Bermuda:          1-800-527-0218
        benefits. Call 24 hours a day (multilingual). If you do not have access to a phone, email for
                                                                                                                              Japan:                                     00531-11-4065
                                                                                                                                           * Dial the first portion of phone number, wait for tone, and then dial remaining numbers.